Organization
RICHARD J. MUTTY MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD J MUTTY MD (PRESIDENT)
(315) 336-3600
Entity
Organization
Contact information
Practice address
1819 BLACK RIVER BLVD N, ROME, NY 13440-2427
(315) 336-3600
(315) 336-5618
Mailing address
1819 BLACK RIVER BLVD N, ROME, NY 13440-2427
(315) 336-3600
(315) 336-5618
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
123964
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00520663
—
NY
Enumeration date
07/08/2006
Last updated
01/28/2010
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